A former dental surgery assistant at Imperial Dental Specialist Centre Sdn Bhd, Noor Azima Mohd Nuwi, 26, said Syed Alman went to the clinic on May 26 last year because his wisdom tooth was causing him pain.

She said an orthopantomogram was carried out on Syed Alman to determine the cause of pain. Based on the results of the X-ray, it was decided that the tooth had to be extracted.

“From the X-ray, Dr Arlena Phillips Lee (who conducted the surgery on Syed Alman) told him that the wisdom tooth had to be extracted.

“Otherwise, it would affect his other teeth and he would be in more pain,” she said during examination-in-chief by deputy public prosecutor Nadia Zulkefli in the trial in which the clinic is facing nine charges relating to Syed Alman’s death.

Azima, who is the tenth prosecution witness, was responsible for assisting the doctor in the surgery room, including in preparing the necessary equipment for the surgery.

Azima also told the court that the deputy prime minister’s son-in-law did ask about the procedures involved in the extraction of his tooth.

She said he was told that he had an option to either be given an injection of the anaesthetic on the gum or surgery by general anaesthesia, which would render him unconscious throughout the surgery.

She said that for both procedures, the patient was required to take a painkiller i.e. either Arcoxia or Ponstan, as well as Augmentin, an antibiotic.

“Dr Arlena explained that if the surgery was performed using general anaesthesia, the clinic would call an anaesthetist from Kuala Lumpur Hospital (HKL) and Dr Arlena also said that if it is general anaesthesia, there is a risk of the patient taking some time to regain consciousness.

“After hearing the explanation, the patient (Syed Alman) opted to have the surgery done using general anaesthesia,” she said.

Following this, she said, Syed Alman made an appointment for the surgery to be done on June 4, 2016, but for reasons unknown, brought it forward to June 1, 2016.

Azima, who is now with Klinik Pergigian Dentistree at Sunway Nexis, said Syed Alman came for the appointment on June 1, 2016 at 5.30pm.

She said besides Arlena, there was another doctor, an anaesthetist known as Dr Ting (Dr Ting Teck Chin) in the surgery room with Syed Alman.

Questioned by Nadia on whether she knew Ting and how she knew if Ting was the specialist anaesthetist for Syed Alman, Azima said she saw Ting conducting the procedure (of administering anaesthesia) on patients.

“I also used to ask my colleagues and they told me that Dr Ting is an anaesthetist from HKL and normally the one to conduct the anaesthesia at Imperial,” she said.

On Aug 12 last year, the company, represented by company director Dr Wong Yen Ling, claimed trial to nine charges in connection with Syed Alman’s death.

Wong, as licence holder, was charged with, among others, failing to ensure that Ting, who administered anaesthesia to Syed Alman, had the qualifications to do so.

The clinic is also accused of failing to ensure that the individuals it engaged to perform the orthopantomogram, anaesthesia and IV sedation on Syed Alman had the necessary qualifications.

It is also accused of failing to put in place, life-saving measures by not providing oxygen as a basic emergency care service as well as failing to submit to University Malaya Medical Centre a copy of all of Syed Alman’s medical records when he was transferred there.

The clinic is also charged with failing to keep and maintain a staff register record, failing to adhere to medicine labelling regulations and failing to take adequate measures to protect its professional healthcare and environment staff from biological hazards.

The offences were allegedly committed at the dental specialist centre located at Lot 62 & 64, Jalan Telawi, Bangsar Baru here between 6pm and 9.05pm, between May 26 and June 2.

Seven of the charges are under Section 31(4), 39(2), 40(4) and 117(2)(b)(i) of the Private Healthcare Facilities and Services Act 1998, which provides for a fine of between RM30,000 and RM300,000, upon conviction.

The other two charges are under Regulation 49(7) and 245(6) of the Private Healthcare Facilities and Services (Private Hospitals and Other Private Healthcare Facilities) Regulations 2006, which carry a fine of up to RM10,000 or three months imprisonment or both upon conviction.

Lawyer P Sreekant represented Wong on behalf of the dental centre.

The hearing before judge Harmi Thamri Mohamed @ Shaharuddin continues tomorrow.